Effect of fenofibrate on plasma apolipoprotein C-III levels

A systematic review and meta-analysis of randomised placebo-controlled trials

Amirhossein Sahebkar, Luis E. Simental-Mendía, Niki Katsiki, Željko Reiner, Maciej Banach, Matteo Pirro, Stephen Atkin

Research output: Contribution to journalArticle

Abstract

Objectives: This meta-analysis of randomised placebo-controlled clinical trials aimed to assess the effect of fenofibrate on apolipoprotein C-III (apo C-III), a key regulator of triglyceride metabolism. Materials and methods: Randomised placebo-controlled trials investigating the impact of fenofibrate treatment on apo C-III levels were searched in PubMed-Medline, Scopus, Web of Science and Google Scholar databases from inception to 18 August 2017. Quantitative data synthesis was determined by a random-effects model and generic inverse variance method. Sensitivity analysis was conducted using the leave-one-out method. A weighted random-effects meta-regression was performed to evaluate glycaemic parameter confounders. Results: Meta-analysis of 10 clinical trials involving 477 subjects showed fenofibrate therapy decreased apo C-III levels (weighted mean difference (WMD) -4.78 mg/dL, 95% CI -6.95 to -2.61, p<0.001; I266.87%). Subgroup analysis showed that fenofibrate reduced plasma apo C-III concentrations in subgroups of trials with treatment durations of either <12 weeks (WMD -4.50 mg/dL, p=0.001) or ≥12 weeks (WMD: -4.73 mg/dL, p=0.009) and doses of fenofibrate <200 mg/day (WMD -6.33 mg/dL, p<0.001) and >200 mg/day (p=0.006), with no significant difference between the subgroups. Conclusion: This meta-analysis found that fenofibrate therapy significantly decreases apo C-III levels, an effect evident with both short-term treatment and doses less than 200 mg/day.

Original languageEnglish
Article numbere021508
JournalBMJ Open
Volume8
Issue number11
DOIs
Publication statusPublished - 1 Nov 2018

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Apolipoprotein C-III
Fenofibrate
Meta-Analysis
Randomized Controlled Trials
Placebos
Therapeutics
PubMed
Triglycerides
Clinical Trials
Databases

Keywords

  • apolipoprotein C
  • fenofibrate
  • fibrate
  • meta-analysis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effect of fenofibrate on plasma apolipoprotein C-III levels : A systematic review and meta-analysis of randomised placebo-controlled trials. / Sahebkar, Amirhossein; Simental-Mendía, Luis E.; Katsiki, Niki; Reiner, Željko; Banach, Maciej; Pirro, Matteo; Atkin, Stephen.

In: BMJ Open, Vol. 8, No. 11, e021508, 01.11.2018.

Research output: Contribution to journalArticle

Sahebkar, Amirhossein ; Simental-Mendía, Luis E. ; Katsiki, Niki ; Reiner, Željko ; Banach, Maciej ; Pirro, Matteo ; Atkin, Stephen. / Effect of fenofibrate on plasma apolipoprotein C-III levels : A systematic review and meta-analysis of randomised placebo-controlled trials. In: BMJ Open. 2018 ; Vol. 8, No. 11.
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abstract = "Objectives: This meta-analysis of randomised placebo-controlled clinical trials aimed to assess the effect of fenofibrate on apolipoprotein C-III (apo C-III), a key regulator of triglyceride metabolism. Materials and methods: Randomised placebo-controlled trials investigating the impact of fenofibrate treatment on apo C-III levels were searched in PubMed-Medline, Scopus, Web of Science and Google Scholar databases from inception to 18 August 2017. Quantitative data synthesis was determined by a random-effects model and generic inverse variance method. Sensitivity analysis was conducted using the leave-one-out method. A weighted random-effects meta-regression was performed to evaluate glycaemic parameter confounders. Results: Meta-analysis of 10 clinical trials involving 477 subjects showed fenofibrate therapy decreased apo C-III levels (weighted mean difference (WMD) -4.78 mg/dL, 95{\%} CI -6.95 to -2.61, p<0.001; I266.87{\%}). Subgroup analysis showed that fenofibrate reduced plasma apo C-III concentrations in subgroups of trials with treatment durations of either <12 weeks (WMD -4.50 mg/dL, p=0.001) or ≥12 weeks (WMD: -4.73 mg/dL, p=0.009) and doses of fenofibrate <200 mg/day (WMD -6.33 mg/dL, p<0.001) and >200 mg/day (p=0.006), with no significant difference between the subgroups. Conclusion: This meta-analysis found that fenofibrate therapy significantly decreases apo C-III levels, an effect evident with both short-term treatment and doses less than 200 mg/day.",
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AB - Objectives: This meta-analysis of randomised placebo-controlled clinical trials aimed to assess the effect of fenofibrate on apolipoprotein C-III (apo C-III), a key regulator of triglyceride metabolism. Materials and methods: Randomised placebo-controlled trials investigating the impact of fenofibrate treatment on apo C-III levels were searched in PubMed-Medline, Scopus, Web of Science and Google Scholar databases from inception to 18 August 2017. Quantitative data synthesis was determined by a random-effects model and generic inverse variance method. Sensitivity analysis was conducted using the leave-one-out method. A weighted random-effects meta-regression was performed to evaluate glycaemic parameter confounders. Results: Meta-analysis of 10 clinical trials involving 477 subjects showed fenofibrate therapy decreased apo C-III levels (weighted mean difference (WMD) -4.78 mg/dL, 95% CI -6.95 to -2.61, p<0.001; I266.87%). Subgroup analysis showed that fenofibrate reduced plasma apo C-III concentrations in subgroups of trials with treatment durations of either <12 weeks (WMD -4.50 mg/dL, p=0.001) or ≥12 weeks (WMD: -4.73 mg/dL, p=0.009) and doses of fenofibrate <200 mg/day (WMD -6.33 mg/dL, p<0.001) and >200 mg/day (p=0.006), with no significant difference between the subgroups. Conclusion: This meta-analysis found that fenofibrate therapy significantly decreases apo C-III levels, an effect evident with both short-term treatment and doses less than 200 mg/day.

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